TY - JOUR
T1 - Association of atopic dermatitis with smoking
T2 - A systematic review and meta-analysis
AU - Kantor, Robert
AU - Kim, Ashley
AU - Thyssen, Jacob P
AU - Silverberg, Jonathan I
N1 - Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.
PY - 2016/12/1
Y1 - 2016/12/1
N2 - Background Tobacco exposure might be a modifiable risk factor for atopic dermatitis (AD). Objective We examine the association between AD and exposure to tobacco smoke. Methods We performed a systematic review and meta-analysis of observational studies (n = 86) in MEDLINE, EMBASE, Scopus, and Cochrane Library (1823-2015). Quality of evidence was assessed using the Newcastle-Ottawa Scale (NOS). A meta-analysis was performed using random-effects models to estimate pooled odds ratios (OR). Subset analyses were performed for different ages (children, adult), regions, study designs (cross-sectional, longitudinal), study sizes (<5000, ≥5000), study quality (NOS score <6, ≥6), and amount of smoking (mild, extensive). Results A diagnosis of AD was associated with higher odds of active smoking (OR 1.87, 95% confidence interval 1.32-2.63) and exposure to passive smoke (OR 1.18, 95% confidence interval 1.01-1.38), but not maternal smoking during pregnancy (OR 1.06, 95% confidence interval 0.80-1.40). The association between active smoking and AD remained significant in children and adults, all continents studied, and study sizes, but all were cross-sectional designs and had NOS score 6 or greater. Passive smoke was associated with AD in children and adults, cross-sectional studies, South/Central American and African studies, study size less than 5000, and NOS score less than 6. Limitations AD severity and distribution were not assessed. Conclusions Active and passive exposure to smoke are associated with increased AD prevalence.
AB - Background Tobacco exposure might be a modifiable risk factor for atopic dermatitis (AD). Objective We examine the association between AD and exposure to tobacco smoke. Methods We performed a systematic review and meta-analysis of observational studies (n = 86) in MEDLINE, EMBASE, Scopus, and Cochrane Library (1823-2015). Quality of evidence was assessed using the Newcastle-Ottawa Scale (NOS). A meta-analysis was performed using random-effects models to estimate pooled odds ratios (OR). Subset analyses were performed for different ages (children, adult), regions, study designs (cross-sectional, longitudinal), study sizes (<5000, ≥5000), study quality (NOS score <6, ≥6), and amount of smoking (mild, extensive). Results A diagnosis of AD was associated with higher odds of active smoking (OR 1.87, 95% confidence interval 1.32-2.63) and exposure to passive smoke (OR 1.18, 95% confidence interval 1.01-1.38), but not maternal smoking during pregnancy (OR 1.06, 95% confidence interval 0.80-1.40). The association between active smoking and AD remained significant in children and adults, all continents studied, and study sizes, but all were cross-sectional designs and had NOS score 6 or greater. Passive smoke was associated with AD in children and adults, cross-sectional studies, South/Central American and African studies, study size less than 5000, and NOS score less than 6. Limitations AD severity and distribution were not assessed. Conclusions Active and passive exposure to smoke are associated with increased AD prevalence.
KW - Africa
KW - Age Factors
KW - Asia
KW - Central America
KW - Cross-Sectional Studies
KW - Dermatitis, Atopic
KW - Europe
KW - Female
KW - Humans
KW - North America
KW - Pregnancy
KW - Risk Factors
KW - Smoking
KW - South America
KW - Tobacco Smoke Pollution
KW - Journal Article
KW - Meta-Analysis
KW - Review
U2 - 10.1016/j.jaad.2016.07.017
DO - 10.1016/j.jaad.2016.07.017
M3 - Review
C2 - 27542586
SN - 0190-9622
VL - 75
SP - 1119-1125.e1
JO - American Academy of Dermatology. Journal
JF - American Academy of Dermatology. Journal
IS - 6
ER -